Neurocognitive aspects of hyperparathyroidism
https://doi.org/10.14341/omet9507
Abstract
The clinical features of primary hyperparathyroidism (PHPT) are characterized not only by typical end organ damage, including osteopenia/osteoporosis, nephrocalcinosis/renal calculi, pancreatitis, but also by neurocognitive changes, including weakness, easy fatigability, depression, inability to concentrate, memory impairment or subtle deficits, dementia, anxiety, irritability and sleep disturbances. The indications for the surgical treatment of PHPT are markedly elevated serum calcium, end organ damage, younger patients (less than 50 years). Cardiovascular and neurocognitive complications of PHPT are not currently an indication for surgical treatment. The results of the surgical treatment of PHTP are contradictory for neurocognitive symptoms. Some studies have demonstrated an improvement in neurocognitive symptoms after parathyroidectomy (PTE), including patients with mild PHPT. However, randomized trials have not demonstrated the benefits of PTE in patients with mild PHPT for neurocognitive symptoms. There are certain difficulties at evaluation of neurocognitive manifestations of PHPT, and therefore, it is actual to use a specific quality of life questionnaire, assessing cognitive function and memory deficit of the patient. Considering the prevalence of patients with asymptomatic course of PHPT and the absence of typical clinical manifestations of the disease, but with the presence of neurocognitive symptoms, the question of the appropriateness of surgical intervention in such cases remains relevant.
About the Authors
Valeriya O. PoyarkovaI.M. Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation
student
Guzel E. Runova
I.M. Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation
MD, PhD, assistant of the Department of Endocrinology, Faculty of Medicine
Valentin V. Fadeev
I.M. Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation
MD, ScD, professor, corresponding member of the Russian Academy of Sciences, head of the Department of Endocrinology, Director of the Endocrinology Clinic of the Medical Faculty
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Poyarkova V.O., Runova G.E., Fadeev V.V. Neurocognitive aspects of hyperparathyroidism. Obesity and metabolism. 2019;16(1):7-11. (In Russ.) https://doi.org/10.14341/omet9507
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